Boric acid is a chemical compound commonly used for its antiseptic and antifungal properties, often found in various household products and over-the-counter remedies. Its use during breastfeeding is generally not recommended. Understanding the reasons behind this caution is important for nursing parents.
Understanding Boric Acid
Boric acid, a weak acid of boron, typically appears as a white, crystalline solid or powder that readily dissolves in water. This compound is used in various industrial processes, manufacturing, and as an additive in products such as cosmetics, lotions, and mouthwash.
In medical contexts, boric acid is recognized for its mild antiseptic, antiviral, and antifungal characteristics. It is sometimes employed to address minor cuts, burns, and certain infections. For example, it is used in vaginal suppositories to treat conditions like yeast infections and bacterial vaginosis, particularly when other treatments are ineffective.
How Boric Acid Enters Breast Milk
Even when applied topically, such as in vaginal suppositories, boric acid can enter the mother’s bloodstream through systemic absorption. While absorption through intact skin is minimal, vaginal absorption is estimated to be around 6%.
Once absorbed into the maternal bloodstream, boric acid, due to its small size and water solubility, can readily pass into breast milk. The body efficiently distributes boric acid throughout its water compartments, and it does not bind to proteins, facilitating its transfer into milk. Nearly all absorbed boric acid is eliminated predominantly through renal excretion, with a half-life ranging from 13 to 24 hours in adults. This means it takes a significant amount of time for the body to clear it, increasing the likelihood of accumulation in breast milk over time, especially with repeated or prolonged use.
Risks to Nursing Infants
Infants are particularly vulnerable to boric acid exposure due to their immature organ systems, which are less efficient at processing and eliminating substances compared to adults. Their kidneys and liver are still developing, making them less capable of effectively clearing boric acid from their bodies. This reduced ability to excrete the compound can lead to its accumulation, even at doses considered low for adults.
Symptoms of boric acid toxicity in infants include nausea, vomiting, and diarrhea. Skin rashes, often described as an intense red or “boiled lobster” appearance, followed by skin loss, are also reported. Neurological effects can range from irritability, lethargy, and tremors to more severe signs such as convulsions and altered mental status. In severe cases of chronic exposure, there is a risk of liver and kidney dysfunction, anemia, and even death, with seizures and fatalities being more commonly reported in infants than adults.
Safer Options While Breastfeeding
Given the potential risks, it is important for breastfeeding parents to avoid self-treating with boric acid. For conditions like vaginal infections, seeking guidance from a healthcare provider is the safest approach. A medical professional can accurately diagnose the condition and recommend treatments compatible with breastfeeding.
Several alternative treatments for vaginal yeast infections, such as topical antifungal creams like clotrimazole or miconazole, are considered safe for nursing mothers. Oral medications like fluconazole are also often prescribed, as only small amounts transfer into breast milk. For bacterial vaginosis, treatments like oral metronidazole or topical clindamycin are generally recommended. Always consult with a healthcare provider to ensure the chosen treatment is appropriate and safe for both the parent and the infant.